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Ian A Harris, Adrian Traeger, Ralph Stanford, Christopher G Maher, Rachelle Buchbinder
Lumbar spine fusion is a common procedure associated with a high cost burden and risk of serious complications. We aimed to summarise systematic reviews on the effectiveness of lumbar spine fusion for most diagnoses. We found no high-quality systematic reviews and the risk of bias of the randomised controlled trials in the reviews was generally high. The available evidence does not support a benefit from spine fusion compared to non-operative alternatives for back pain associated with degeneration. The available evidence does not support a clinical benefit from spine fusion compared to non-operative treatment or stabilisation without fusion for thoracolumbar burst fractures...
December 2018: Internal Medicine Journal
Vivek Palepu, Melvin Helgeson, Michael Molyneaux-Francis, Srinidhi Nagaraja
Several approaches (anterior, posterior, lateral, and transforaminal) are used in lumbar fusion surgery. However, it is unclear whether one of these approaches has the greatest subsidence risk as published clinical rates of cage subsidence vary widely (7-70%). Specifically, there is limited data on how a patient's endplate morphometry and trabecular bone quality influences cage subsidence risk. Therefore, this study compared the subsidence between anterior (ALIF), lateral (LLIF), posterior (PLIF), and transforaminal (TLIF) lumbar interbody fusion cage designs to understand the impact of endplate and trabecular bone quality on subsidence...
December 5, 2018: Journal of Biomechanical Engineering
S P Mohanty, M Pai Kanhangad, B Yogesh Kumar, A Singh
PURPOSE: The present study evaluated the clinical and radiological outcomes in patients with tuberculosis of the thoracic and thoracolumbar spine, treated by an operative technique in which anterior debridement with posterior instrumentation and global fusion was performed through a single-stage posterior approach. METHODS: Ninty-seven patients with spinal tuberculosis, between T1 and L1, in whom anterior debridement, bone grafting, with posterior instrumentation and fusion was performed through a single-stage posterior approach, with a minimum follow-up of 2 years, formed the basis of this study...
December 4, 2018: Musculoskeletal Surgery
Lisbeth Storm, Rikke Rousing, Mikkel O Andersen, Leah Y Carreon
INTRODUCTION: The Subgroups for Targeted Treatment (STarT) Back Screening Tool is used in general practice to stratify patients with acute back pain into either a low, medium or a high risk of developing complex pain. This study determines if the STarT Back Screening Tool can identify patients who are at a high risk of developing complex pain after spine surgery. METHODS: The STarT Back Screening Tool was administered pre-operatively to a consecutive series of patients who had lumbar spine surgery between 29 October 2012 and 1 February 2013...
December 2018: Danish Medical Journal
Jianzhong Jiang, Fengping Gan, Haitao Tan, Zhaolin Xie, Xiang Luo, Guoxiu Huang, Yin Li, Shengbin Huang
The benefits of navigation-assisted technologies are not entirely understood. Therefore, this study aimed to examine the outcomes of patients with lumbar tuberculosis who received computer navigation-assisted minimally invasive direct lateral interbody fusion (DLIF).This was a retrospective study of 33 patients with lumbar tuberculosis who underwent minimally invasive DLIF at the Department of Spine and Orthopedics of Guigang People's Hospital (Guangxi, China) between January 2015 and December 2016. The patients were pathologically diagnosed as lumbar tuberculosis and grouped into the navigation-assisted fluoroscopy (NAV; n = 18) and non-navigation-assisted fluoroscopy (non-NAV; n = 15) groups...
November 2018: Medicine (Baltimore)
Lingde Kong, Changjun Sun, Ningzhao Kou, Jiangbo Bai, Jingtao Zhang, Jian Lu, Dehu Tian
Few clinical studies investigate risk factors associated with clinical adjacent segment pathology (CASP) following multi-level cervical fusion surgery. The aim is to record the incidence of postoperative CASP in patients after at least 2 years' follow-up and to identify possible risk factors that may be associated with the CASP after multi-level cervical surgery.We retrospectively reviewed patients who underwent multi-level cervical surgery in our hospital from January 2004 to February 2016. All patients underwent more than 2 years' follow-up...
November 2018: Medicine (Baltimore)
Suomao Yuan, Bin Wei, Yonghao Tian, Jun Yan, Wanlong Xu, Lianlei Wang, Xinyu Liu
Case series study.To report the clinical outcomes of posterior temporary C1-2 fixation for 3-part fracture of the axis (Type II odontoid fracture according to Grauer classification combined with Hangman fracture).The 3-part fracture of the axis is rare and the treatment is controversy.A total of 8 patients with 3-part fracture of the axis were included in this study. X-rays, CT, and MRI prior to surgery were used to evaluate the cervical spine injury. Grauer classification, fracture angulation, and fracture translation were used to evaluate the fracture of dens...
November 2018: Medicine (Baltimore)
Joseph Meyerson, Andrew O'Brien, Nicholas Calvin, Rajiv Chandawarkar
BACKGROUND: Reconstruction of complex back defects, especially after corrective spine surgery, is a challenging problem. In these patients hardware issues predominate and flap failure has serious consequences. Certain subunits of the back pose even greater problems, specifically the central region between T9 and T12. The purpose of this article is to present a novel technique for reconstruction of such spinal defects using a newly described trapezius muscle propeller flap based on the dorsal scapular vessels...
December 3, 2018: Microsurgery
Zorica Buser, Andrew S Chung, Aidin Abedi, Jeffrey C Wang
Low back and neck pain are among the top contributors for years lived with disability, causing patients to seek substantial non-operative and operative care. Intervertebral disc herniation is one of the most common spinal pathologies leading to low back pain. Patient comorbidities and other risk factors contribute to the onset and magnitude of disc herniation. Spine fusions have been the treatment of choice for disc herniation, due to the conflicting evidence on conservative treatments. However, re-operation and costs have been among the main challenges...
November 30, 2018: International Orthopaedics
Ju-Eun Kim, Dae-Jung Choi
Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention...
December 2018: Clinics in Orthopedic Surgery
Ju-Eun Kim, Dae-Jung Choi, Eugene J Park
Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment...
December 2018: Clinics in Orthopedic Surgery
Eva Jacobs, Barend J van Royen, Sander M J van Kuijk, Johannes M R Merk, Agnita Stadhouder, Lodewijk W van Rhijn, Paul C Willems
BACKGROUND CONTEXT: - Surgery for adult spinal deformity (ASD) is a challenging and complex procedure with high reported complication (8.4-42%) and revision rates (9-17.6%). Failure to achieve or maintain adequate postoperative sagittal alignment has been reported to be the main cause of mechanical complications. In order to define appropriate surgical targets, the Scoliosis Research Society (SRS)-Schwab classification and the Global Alignment and Proportion (GAP) score were established...
November 29, 2018: Spine Journal: Official Journal of the North American Spine Society
Janni Strøm, Claus Vinther Nielsen, Lene Bastrup Jørgensen, Niels Trolle Andersen, Malene Laursen
BACKGROUND: Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSE: To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life...
November 27, 2018: Spine Journal: Official Journal of the North American Spine Society
Karin Wuertz-Kozak, Dominique Bleisch, Najia Nadi, Peter Prömmel, Wolfgang Hitzl, Thomas M M Kessler, Oliver P Gautschi, Oliver N Hausmann
AIMS: Anterior lumbar interbody fusion procedures (ALIF) and total disc replacement (TDR) with anterior exposure of the lumbar spine entail a risk of a vascular injury and dysfunction of the sympathetic and parasympathetic nerves due to disturbance of the inferior and superior hypogastric plexus. While retrograde ejaculation is a known complication of the anterior spinal approach in males, post-operative sexual as well as urinary function in females has not yet been thoroughly investigated and was hence the aim of this study...
November 29, 2018: Neurourology and Urodynamics
(no author information available yet)
OBJECTIVEDiagnostic workup for lumbar degenerative disc disease (DDD) includes imaging such as radiography, MRI, and/or CT myelography. If a patient has unsuccessful nonoperative treatment, the surgeon must then decide if obtaining updated images prior to surgery is warranted. The purpose of this study was to investigate whether the timing of preoperative neuroimaging altered clinical outcome, as reflected by the subsequent rate of revision surgery, in patients with degenerative lumbar spinal pathology.METHODSFrom the Health Care Service Corporation administrative claims database, adult patients (minimum age 55 years old) with lumbar DDD who underwent surgery including posterior lumbar decompression with and without fusion (1-2 levels) and at least 5 years of continuous coverage after the index surgery were identified...
November 1, 2018: Journal of Neurosurgery. Spine
Manuel Fernandes Marques, Luís Henrique Barros, Bruno Lopes Correia, Eurico Lopes da Silva, Ricardo Rodrigues-Pinto
CASE: We report a case of postoperative left-sided Horner syndrome (blepharoptosis, miosis, and anhidrosis) after revision surgery for cervical spondylotic myelopathy. A C4 corpectomy and an anterior cervical fusion from C3 to C5 were performed through a left longitudinal approach in a patient with a surgical history of an anterior discectomy and a fusion from C5 to C6. One year after the revision surgery, the patient had recovered from the anhidrosis and the miosis, but the blepharoptosis was not fully resolved...
November 28, 2018: JBJS Case Connector
Edward Compton, Patrick Heindel, Blake Formanek, Kyle Schoell, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: This study's objective was to determine whether perioperative invasive vascular catheter placement, independent of comorbid conditions, modified the risk of postoperative infection in lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Infection is a risk inherent to lumbar spine surgery, with overall postoperative infection rates of 0.86%-8.5%. Patients experiencing postoperative infection have higher rates of mortality, revision surgeries, pseudarthrosis, and worsening pain and disability...
November 26, 2018: Clinical Spine Surgery
Liedewij Bogaert, Peter Van Wambeke, Tinne Thys, Thijs Willem Swinnen, Wim Dankaerts, Simon Brumagne, Lieven Moke, Koen Peers, Bart Depreitere, Lotte Janssens
PURPOSE: Bracing is frequently prescribed following lumbar surgery for degenerative conditions. However, previous studies failed to demonstrate the advantage of postoperative lumbar bracing in both short- and long-term outcome in terms of pain, quality of life and fusion rate. The purpose of this study was to assess the prescription patterns and rationale for postoperative bracing amongst spinal surgeons in Belgium. METHODS: A 16-item online survey was distributed by email to spinal surgeons affiliated to the Spine Society of Belgium (N = 252)...
November 28, 2018: European Spine Journal
Hyosang Lee, Ui Chul Kim, Jae Keun Oh, Taehyun Kim, Sohee Park, Yoon Ha
Objective: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease. Methods: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis...
November 30, 2018: Journal of Korean Neurosurgical Society
(no author information available yet)
OBJECTIVEThe surgical correction of adult spinal deformity (ASD) often involves modifying lumbar lordosis (LL) to restore ideal sagittal alignment. However, corrections that include large changes in LL increase the risk for development of proximal junctional kyphosis (PJK). Little is known about the impact of cranial versus caudal correction in the lumbar spine on the occurrence of PJK. The goal of this study was to investigate the impact of the location of the correction on acute PJK development.METHODSThis study was a retrospective review of a prospective multicenter database...
October 1, 2018: Journal of Neurosurgery. Spine
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